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Tests for gallbladder cancer

Men and women discussing gallbladder cancer

This page is about tests for gallbladder cancer. There is information about

 

A quick guide to what's on this page

Tests for gallbladder cancer

Most people begin by seeing their GP. Your GP will ask about your symptoms and your general health. Your doctor will examine you, including feeling your abdomen and the lymph nodes in your neck. Your doctor may refer you to hospital for tests and X-rays or may ask you to see a specialist first. This is usually a gastroenterologist, who is a specialist in diseases of the digestive system.

At the hospital

The specialist will ask about your medical history and symptoms. He or she will examine you, feeling your abdomen for any signs of swelling. Your specialist will check the whites of your eyes and your skin for any yellowing, which is a sign of jaundice. He or she may look at and feel the lymph glands in your neck and in your groin to see if any are swollen.

Depending on the examination results, you may have some blood tests, a CT scan and an ultrasound scan. Your doctor may also arrange an ERCP (endoscopic retrograde cholangiopancreatography).

Biopsy and fine needle aspiration (fna)

You may have a biopsy. This is the only certain way to tell whether a growth is a cancer or not. But if your doctor is fairly certain from the results of your other tests that you have a cancer, you may not need a biopsy.

 

CR PDF Icon You can view and print the quick guides for all the pages in the diagnosing gallbladder cancer section.

 

Seeing your GP

If you think you might have a gallbladder problem, you usually begin by seeing your family doctor, who will examine you and ask about your general health. Your doctor will ask you about your symptoms. This will include what they are, when you get them and whether anything you do makes them better or worse.

Your doctor will examine you, including feeling your abdomen and the lymph nodes (glands) in your neck. After your examination, your doctor may refer you to hospital for tests and X-rays or may ask you to see a specialist first. The specialist is usually a gastroenterologist, who is an expert in diseases of the digestive system.

 

At the hospital

The specialist will

  • Ask you about your medical history and symptoms
  • Examine you again, including feeling your abdomen for any signs of swelling
  • Check the whites of your eyes and your skin for any yellowing (a sign of jaundice)
  • Look at and feel the lymph glands in your neck and in your groin to see if any are swollen

Your specialist will feel your glands because gallbladder cancer may spread to the lymph glands. If the lymph glands contain cancer cells, the glands may feel larger than normal.

Depending on the results of your examination, your specialist may arrange some tests. You may have

You may have more than one type of scan. This is because a cancer may show up on one type of scan but not so well on another, depending on its size and where it is. If your scans show anything abnormal in or around your gallbladder, your specialist may arrange

 

Blood tests

Your specialist will arrange blood tests called liver function tests. This series of tests shows if the liver and gallbladder are working normally. Included is a test for a chemical called bilirubin. Bilirubin is a chemical in bile. A small amount of bilirubin in your blood is perfectly normal. But a high level usually means you have a problem with your gallbladder or liver.

 

Ultrasound scan

Your doctor may use this type of scan to look at your gallbladder. Ultrasound can pick up about 1 in 2 gallbladder cancers. This scan uses sound waves to create pictures of your body. If there is a tumour in your gallbladder, your doctor may be able to tell if the cancer has spread into the wall of the gallbladder.

Ultrasound is completely painless and is harmless. There is more about having an ultrasound scan in the section about cancer tests.

 

CT scan

A CT is a computerised scan using X-rays. Your specialist may suggest you have a CT scan of your abdomen. CT scans of the gallbladder can pick up a growth inside the gallbladder, or one that is growing outside the gallbladder. CT scans are also helpful to see if the cancer has spread to the common bile duct, to nearby lymph nodes or to the liver. There is more about having a CT scan in the section about cancer tests.

 

ERCP

ERCP stands for endoscopic retrograde cholangiopancreatography. You swallow a long, flexible tube so your doctor can look at the inside of your small bowel (duodenum) and take biopsies of anything that looks abnormal. This test can show a narrowing or blockage of the bile duct or pancreatic duct. So it can also help with planning surgery. The whole test takes anything from 30 minutes to 2 hours.

There is detailed information about having an ERCP in the section about cancer tests.

 

MRI scan with MRCP

MRCP is short for magnetic resonance cholangiopancreatography. It's a type of MRI scan. It uses radio signals to give detailed pictures of your pancreas, gallbladder and bile ducts.

You may have an MRI scan of your abdomen at the same time as the MRCP. To prepare for this you must have nothing to eat or drink for 4 to 5 hours beforehand. If you have just the MRCP you only need to have nothing to eat or drink for 2 hours. You then have to lie very still inside an MRI machine for up to 30 minutes.

It's not as uncomfortable as an ERCP so you don't need any painkillers or other drugs. And you don't need to swallow a dye or have a dye injected, as you do with a CT scan. But with an MRCP, doctors can't take samples of any lumps they find. And MRCP isn't available in all hospitals.

 

Biopsy and fine needle aspiration (FNA)

A biopsy means removing a sample of tissue and looking at it under a microscope. This is the only certain way to tell whether a growth is a cancer or not. But if your doctor is fairly certain from the results of your other tests that you have a cancer, you may not need a biopsy. If you have an inflamed gallbladder or have gallstones, you may not need to have a biopsy because your gallbladder will probably be removed anyway. In all these situations, your surgeon will send some gallbladder tissue for examination under a microscope at the time of your operation.

If you do need a biopsy, it can be done in a number of different ways. You may have biopsy tissue removed during a laparoscopy, during ERCP or with a fine needle aspiration (fna).

For FNA, you need to have an ultrasound scan or CT scan. The doctor uses the scan to guide a very thin needle through your skin and into the liver and gallbladder. Once the needle is in the right place, the doctor draws a sample of cells into the needle and sends the specimen to the lab to be looked at under a microscope. You may have a fine needle biopsy of your liver or lymph glands to find out if a gallbladder cancer has spread. To do this, the doctor puts the needle into one of the large lymph glands and draws out fluid that is examined for cancer cells.

Following a gallbladder biopsy, you will have to stay in hospital for a few hours or overnight. This is because there is a risk of bleeding afterwards.

You will not get the results of your biopsy straight away. It takes a while for the pathology department to prepare the samples before they can look for cancer cells. Don't forget to ask the doctor when the results will be ready and how you will get them.

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Updated: 30 August 2012